Monday, March 4, 2013

It's My Choice, Or Perhaps Not?

Individual Autonomy

An article, by Cass R. Sunstein, in The New York Review of Books looks at the important and divisive issue on how much autonomy individuals require, and when is it both necessary and good for the state to intervene in the lives of its citizens. In reviewing Sarah Conly's book, Against Autonomy: Justifying Coercive Paternalism, Sunstein brings in both philosophy (i.e., John Stuart Mill's "On Liberty") and the rcent findings of decision-making science (i.e., the work of Daniel Kahneman and Amos Tversky) to question whether and when governments, and their social and health agencies, ought to more directly intervene—so-called state paternalism or nanny states—in the lives of individuals, notably if it seems they are making poor choices. It's essentially an argument against too much freedom of choice.

Sunstein writes:
A great deal of research finds that most people are unrealistically optimistic, in the sense that their own predictions about their behavior and their prospects are skewed in the optimistic direction.6 In one study, over 80 percent of drivers were found to believe that they were safer and more skillful than the median driver. Many smokers have an accurate sense of the statistical risks, but some smokers have been found to believe that they personally are less likely to face lung cancer and heart disease than the average nonsmoker.7 Optimism is far from the worst of human characteristics, but if people are unrealistically optimistic, they may decline to take sensible precautions against real risks. Contrary to Mill, outsiders may be in a much better position to know the probabilities than people who are making choices for themselves.
Emphasizing these and related behavioral findings, many people have been arguing for a new form of paternalism, one that preserves freedom of choice, but that also steers citizens in directions that will make their lives go better by their own lights.8 (Full disclosure: the behavioral economist Richard Thaler and I have argued on behalf of what we call libertarian paternalism, known less formally as “nudges.”9) For example, cell phones, computers, privacy agreements, mortgages, and rental car contracts come with default rules that specify what happens if people do nothing at all to protect themselves. Default rules are a classic nudge, and they matter because doing nothing is exactly what people will often do. Many employees have not signed up for 401(k) plans, even when it seems clearly in their interest to do so. A promising response, successfully increasing participation and strongly promoted by President Obama, is to establish a default rule in favor of enrollment, so that employees will benefit from retirement plans unless they opt out.10 In many situations, default rates have large effects on outcomes, indeed larger than significant economic incentives.11
Default rules are merely one kind of “choice architecture,” a phrase that may refer to the design of grocery stores, for example, so that the fresh vegetables are prominent; the order in which items are listed on a restaurant menu; visible official warnings; public education campaigns; the layout of websites; and a range of other influences on people’s choices. Such examples suggest that mildly paternalistic approaches can use choice architecture in order to improve outcomes for large numbers of people without forcing anyone to do anything.
In the United States, behavioral findings have played an unmistakable part in recent regulations involving retirement savings, fuel economy, energy efficiency, environmental protection, health care, and obesity.12 In the United Kingdom, Prime Minister David Cameron has created a Behavioural Insights Team, sometimes known as the Nudge Unit, with the specific goal of incorporating an understanding of human behavior into policy initiatives.13 In short, behavioral economics is having a large impact all over the world, and the emphasis on human error is raising legitimate questions about the uses and limits of paternalism.

Until now, we have lacked a serious philosophical discussion of whether and how recent behavioral findings undermine Mill’s harm principle and thus open the way toward paternalism. Sarah Conly’s illuminating book Against Autonomy provides such a discussion. Her starting point is that in light of the recent findings, we should be able to agree that Mill was quite wrong about the competence of human beings as choosers. “We are too fat, we are too much in debt, and we save too little for the future.” With that claim in mind, Conly insists that coercion should not be ruled out of bounds. She wants to go far beyond nudges. In her view, the appropriate government response to human errors depends not on high-level abstractions about the value of choice, but on pragmatic judgments about the costs and benefits of paternalistic interventions. Even when there is only harm to self, she thinks that government may and indeed must act paternalistically so long as the benefits justify the costs.
Such are the kinds of questions that are important to raise, especially now that society has become more complicated, and equally important now that scientific research is showing, if not explaining, how our human brains work. Most people, I sense, prefer a high degree of autonomy, enjoying the making of informed decisions; informed is an important consideration here. Yet, not all persons do, either through natural inclination or lack of time; for that reason, some enjoy that others make it for them. Is this coercive state paternalism?

Perhaps. Libertarains will see in all forms of government intervention and sanctions the state overstepping its bounds. Others might argue, with good cause, that we might have too much personal autonomy, which is not the same as individual liberty in the areas that really matter, and this has consequently lead to difficulty in making good choices.

Yet, no individual has complete and total liberty; laws, many for our good, restrict our freedom, including the freedom to do harm. One of the chief questions is at what point should the state intervene in the life of an individual? The obvious cases of inflicting harm to self or others are examples that no rational person would argue against. It's the other more grey areas that demand thought and justification, balancing the rights of the individual with the rights of society in general.

We know, for example, that ciagearette smoking is without question bad for the health; should the state find more paternalistic ways to discourage cigarette smoking? How about the health-care costs associated with medical care as a result of taking illicit drugs? binge drinking smoking? over-eating? Should everyone be treated equally? Should risk-takers pay more, knowing such individuals are taking known risks with their health? How much responsibility does the state have for the individual? Such are always the most difficult questions to answer. Yet, will have to come up with some reasonable answers to these and more troubling human questions fairly soon, notably as our human choices increase and the costs to these choices also increase.

Despite the many individuals who say they know with certainty what is always the right or correct view or answer, I am not always so sure.

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You can read the rest of the article at [NYRB].